title: Older adult opinions about driving cessation: a role for advanced driving directives.
abstract: OBJECTIVE
  To describe older adults' opinions about driving cessation and driver retesting.
  
  
  METHODS
  Older adult (≥ 65 years) patients visiting the emergency department or geriatric clinic at a university hospital completed a confidential survey regarding attitudes toward driving tests and restrictions.
  
  
  RESULTS
  The response rate was 50% (N = 169). The median age was 75 years (range, 65-98); 53% were women. Most reported driving at least occasionally (78%; 95% confidence interval [95% CI], 72-84). Twelve percent (95% CI, 7-18) reported a crash in the prior year; most (84%; 95% CI, 78-90) reported at least 1 medical diagnosis possibly linked to increased crash risk. Most participants (74%; 95% CI, 67-81) supported mandatory, age-based driver retesting but thought family (73%; 95% CI, 68-81) or physicians (60%; 95% CI, 54-69) should determine license revocation for an unsafe driver rather than the Department of Motor Vehicles (34%; 95% CI, 28-42) or the police (30%; 95% CI, 23-37). Almost all reported they would consider driving cessation if recommended by a physician (88%; 95% CI, 82-94) or family member (71%; 95% CI, 63-79), without significant age or sex differences.
  
  
  CONCLUSIONS
  Older drivers support mandatory age-based testing but appear more likely to follow recommendations from physicians or family members, thereby supporting a role for physician counseling, driver evaluations, and advanced driving directives.
authors.affiliation: School of Medicine, University of Colorado, Denver, USA.
authors.forename: Marian E
authors.initials: ME
authors.lastname: Betz
authors.forename: Robert
authors.initials: R
authors.lastname: Schwartz
authors.forename: Morgan
authors.initials: M
authors.lastname: Valley
authors.forename: Steven R
authors.initials: SR
authors.lastname: Lowenstein
keywords: advanced directives; counseling; driver testing